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General NPI Number Information
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NPI Number | 1568828341
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Entity Type | Organization
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Legal Business Name | CAREQOR WELLNESS, LLC
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Dates
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Enumeration Date | 01/08/2016
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 270 TRACE COLONY PARK DR
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City | RIDGELAND
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State | MS
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Zip | 39157-8810
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Country | US
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Telephone | 314-399-8622
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Fax |
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Provider Business Mailing Address
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Address Line | 720 OLIVE ST APT 2104
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City | SAINT LOUIS
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State | MO
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Zip | 63101-2302
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | KAY WILLIAMS
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Credential |
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Telephone | 314-399-8622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 899542
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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